Depositor Copy

Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch

Date: 22-07-2015

CP25611609

Beneficiary:

Railway Recruitment Board

Merchant Reference No:

12563311185674041

Pre Acknowledgement Payment(PAP) Form for Payment through any SBI Branch
Branch Teller: Use SCR 008765 Deposit > Fee Collection > State Bank Collect

Benificiary/Remittance Details
State Bank MOPS Reference No.

Branch Copy

Date: 22-07-2015

Benificiary/Remittance Details
Rs

Collection Amount
Comission
Total ( One HundredRupees Only)

P
100 00
0 00
100 00

State Bank MOPS Reference No.

CP25611609

Beneficiary:

Railway Recruitment Board

Merchant Reference No:

12563311185674041
Rs

Details of Cash / Cheques

Rs

Collection Amount
Comission
Total ( One HundredRupees Only)

100 00
0 00
100 00

Mode of Payment (Choose Either Cash / Cheque)

Total Rs

Cash

Instructions for Depositor: This is not an e-receipt.

Amount

Cash Notes

Rs

*1000
*500
*100

(To be Filled in by the Bank)

*50
Journal No:

CP25611609

*20
*10

Branch Name:
Branch Code:

Coins
Total Rs

Deposit Date:
Cheque
Branch Stamp

Cheque No:
Cheque Date:

Authorised Signatory

Drawee Bank & Branch: State Bank of India

Branch :
Signature of the Depositor

Space for Bank use

Branch Stamp